Shannon L Boyer, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0036398 Issued in FL

Practice address

2702 Rew Cir
Suite a
Ocoee, FL 34761-4226

Phone

(407) 656-5505

Fax

(407) 656-9688

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1407963010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 REW CIR",
            "address_2": "SUITE A",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614226",
            "telephone_number": "407-656-5505",
            "fax_number": "407-656-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 REW CIR",
            "address_2": "SUITE A",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614226",
            "telephone_number": "407-656-5505",
            "fax_number": "407-656-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYER",
        "first_name": "SHANNON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0036398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039822500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID",
            "identifier": "M3CO4",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Kathryn Borno, LCSW
• Slyving Daton Bourdeau, LCSW
• William Kelly Bowman, M.D.
• Nadia J Bowser, PMHNP-BC
• Aleksandra Kotrina Box
• William Bradford, MD
• Carolina Brandan, MD
• Bridgett Kenetra Breeden
• Breck Brewer, DDS
• Brian T. Burry, O.D., P.a.

• Ophthalmology Physician in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.